| NPI | 1053617688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENEVE DEON CLARKE Registered Nurse 678-526-5095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: GA 179755) |
| Enumeration Date | 2011-01-30 |
| Last Update Date | 2011-01-30 |